<div style="width: 296px; border: 2px solid #cecfce; text-align:center; 
    background-color: #eee;">
<form action="http://repsheet.com/" type="get">
    <p style="margin:0; padding: 10px 0 5px 0; font-size:12px;font-family:arial,verdana,georgia;font-weight:bold;">Look up your elected representatives in Chicago.</p>
    <input type="text" name="location" `
    style="font-size: 12px; width: 225px; color: #bbb;" 
    value="Chicago street address or Zip code" 
    onfocus="if (this.value==this.defaultValue) { 
    this.value=''; this.style.color='#000'; }" 
    onblur="if (this.value=='') { 
    this.value=this.defaultValue; this.style.color='#bbb'; }" />
    <input type="submit" name="submit" value="Go" style="font-size:15px; width:50px;" />
    <p style="margin:0; padding: 10px 0 0 20px;font-family:arial,verdana,georgia; font-size: 14px;">Powered by <a href="http://repsheet.com"><img 
    src="http://repsheet.com/media/img/logos/replogo_85w_eee.gif" 
    style="border:none; vertical-align: bottom;" /></a></p>
</form>
</div>
